POS0233 DISEASE COURSE AND PREDICTORS FOR ACHIEVING 6-MONTH MINIMAL DISEASE ACTIVITY IN PATIENTS WITH EARLY PSORIATIC ARTHRITIS FROM THE ITALIAN PROSPECTIVE SIRENA STUDY
Authors: A. Zabotti, M. M. Luchetti, C. Selmi, R. Ramonda, R. D. Grembiale, S. D’angelo, S. Marelli, E. Favalli
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Data on Psoriatic Arthritis (PsA) patients naive to any Disease Modifying Anti-Rheumatic Drugs (DMARDs) are limited. <h3>Objectives</h3> To describe the clinical course and predictors for achieving Minimal Disease Activity (MDA) in PsA patients starting DMARDs in a real-world setting. <h3>Methods</h3> PsA patients were enrolled in SIRENA (Clinicaltrials.gov identifier NCT03131661), an Italian Registry of Spondyloarthritis (SpA) patients classified according to ASAS criteria and naive to any DMARDs for SpA [1]. Clinical data were collected at baseline and every 6 months up to the 24-month observation period. Predictors of 6-month MDA were identified through univariate and multivariate analyses. <h3>Results</h3> Out of 350 SpA cases, 203 patients received a diagnosis of PsA (at baseline: mean age 51.2 years; men 51.7%; newly diagnosis 77.3%; time to diagnosis &lt;24 months 68%; mainly axial 4.4%; monoarticular/oligoarticular/polyarticular 9.9/31.5/48.8%; active skin psoriasis 84.3%; enthesitis 38.5%; dactylitis 24%; nail psoriasis 39.7%). At baseline, 100/203 patients (49.3%) were prescribed conventional DMARDs, 50 (24.6%) biological DMARDs and 27 (13.3%) other systemic treatments, mostly non-steroidal anti-inflammatory drugs. During the 2-year observation period, 79 patients (38.9%) started the first biologic after a conventional DMARD with a median time of 6.8 months and a second biologic after 10.0 months. Clinical and Patient Reported Outcomes markedly improved overtime (Table 1). MDA was achieved by 102/158 patients (64.6%) at least once in the observation period (median time to first MDA according to Kaplan-Meier: 10 months) and by 65/150 patients (43.3%) at 6 months. In univariate analysis, female gender, Body Surface Area (BSA) &lt;3% and higher scores in Health Assessment Questionnaire-Disability Index (HAQ-DI) were associated with a decreased odds ratio of reaching MDA at 6 months while mono-oligoarticular involvement, newly PsA diagnosis and lower Disease Activity in PSoriatic Arthritis (DAPSA) score were associated with an increased odds ratio (Figure 1). Smoking, alcohol, presence of enthesitis/dactylitis/nail psoriasis, Disease Activity Score-28 (DAS-28), number of comorbidities, body mass index and patient VAS global assessment (PtGA) were not significantly associated with 6-month MDA achievement. In multivariate analyses no factor was identified as significant predictor of MDA at 6 months. <h3>Conclusion</h3> In an early PsA population, treatments with predominantly conventional DMARDs and biologics markedly improved disease outcomes, with 43% of patients achieving MDA at 6 months. Female gender, BSA &lt;3% and higher HAQ-DI scores were associated with a decreased odds ratio while new PsA diagnosis, mono-oligoarticular involvement and lower DAPSA score were associated with an increased odds ratio for 6-month MDA. <h3>Reference</h3> [1]Zabotti A, et al. Front Med 2021;8: 711875. <h3>Acknowledgements</h3> The authors thank Carlotta Galeone - Statinfo srl - for providing medical writing support. <h3>Disclosure of Interests</h3> Alen Zabotti Speakers bureau: Abbvie, Novartis, Janssen, Lilly, UCB and Amgen, Paid instructor for: Abbvie, Novartis and UCB, Michele Maria Luchetti Speakers bureau: Janssen, Abbvie, Novartis, Lilly, Celgene and Pfizer, Carlo Selmi Speakers bureau: AbbVie, Amgen, Celgene, Eli-Lilly, Janssen, Novartis, Pfizer and Sanofi-Regeneron, Grant/research support from: Amgen, Janssen, Novartis and Pfizer, Roberta Ramonda Speakers bureau: Novartis, Abbvie, Pfizer, MSD and Janssen, Rosa Daniela Grembiale: None declared, Salvatore D'Angelo Speakers bureau: AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Sanofi and UCB, Silvia Marelli Shareholder of: J&amp;J, Employee of: Janssen, Ennio Favalli Speakers bureau: AbbVie, Bristol-Myers Squibb, Lilly, Merck Sharp and Dohme, Pfizer, Galapagos, Janssen, Sanofi-Genzyme and UCB.